Milling block, method for producing partial or total prostheses, and complete milling block system

ABSTRACT

The invention relates to a milling block ( 1 ) for producing partial or total prostheses, comprising a prosthesis base ( 3 ) to be processed according to the shape of the jaw, on which synthetically moulded teeth ( 5 ), preferably a full set of teeth, are provided, a milling block system consisting of a first milling block for the upper set of teeth and a second milling block for the lower set of teeth, and a method for producing partial or total prostheses.

This application is a continuation and claims the priority under 35U.S.C. § 120 to U.S. application Ser. No. 14/357,565, filed May 10,2014, which is a U.S. National Stage Application under 35 U.S.C. § 371of and claims priority to International Application NumberPCT/EP2012/004665, filed Nov. 9, 2012, which claims the benefit ofpriority to Application No. 10 2011 118 320.9, filed Nov. 11, 2011, theentire contents of each of which are hereby incorporated by reference.

The invention relates to a milling block, to a method for producingpartial or total prostheses and to a complete milling block systemconsisting of a first milling block for the upper set of teeth and asecond milling block for the lower set of teeth and to a method forproviding a partial or total prosthesis.

A method for producing a total prosthesis with an upper and/or lower jawbase with the aid of a milling device is already known from EP 0 501 983B1, the respective base being milled from a synthetic block and data onthe oral cavity characterising the contour or topography being used.This method described therein also uses, after preparing the adaptedbase for the oral cavity, the further procedural step of positioning therequired teeth in wax on the upper and/or lower jaw base, the prosthesisbeing completed by connecting the teeth to the base with the aid of acold-curing polymer. Next the so-called reocclusion takes place so thatthe respective patient is provided with an optimal bite according to thelatter's chewing movements.

This known method is therefore associated with the disadvantage thatafter completion of the upper and/or lower jaw base individualadaptation to the patient by appropriately positioning the teeth in waxis required, and this in turn makes the whole treatment sequence for thedentist and dental technician time-consuming and expensive.

It is therefore the object of the following invention to provide amilling block and a method for producing partial or total prostheses aswell as a complete milling block system which avoid the disadvantages ofthe prior art. Furthermore, it is the object of the following inventionto reduce the working steps for individual adaptation to the patient.

According to the invention it is proposed in order to achieve theobjects to provide a milling block for producing partial or totalprostheses wherein a prosthesis base with synthetically moulded teeth ofa full set of teeth is provided that is to be processed according to theshape of the jaw. Within this context, the corresponding milling blocksystem is also equipped as regards the upper set of teeth and the lowerset of teeth independently of the fastening in the mouth.

With this measure according to the application it is made possible foronly the prosthesis base to have to be milled or moulded, and withcorrect milling according to given CAD/CAM data on the oral cavity ofthe patient no further adaptation has to be made due to syntheticallymoulded teeth already anchored on the prosthesis base.

By appropriately optimised adaptation and adjustment of the prosthesisbase to the oral cavity just one individual adaptation step is thereforerequired in order to provide for the patient optimally.

Due to the presence of a milling block or milling block system accordingto the application wherein there is an appropriate jaw shape for theprosthesis base to be processed with synthetically moulded teeth, oneneed neither take an impression of the bite in order to determine themaxillomandibular relationship nor undertake a time-consuming andexpensive fitting.

With the measure according to the application subsequent insertion intoan articulator to determine the positioning of the teeth is nottherefore required because the synthetically moulded teeth are alreadyprepared according to given basic data for the occlusion position.

According to the method according to the application for providing apartial or total prosthesis it is therefore possible that on the basisof the presence of upper and lower rows of teeth present in the form ofthe set of teeth in the occlusion position at least three differentmilling block systems in different proportions in the form of the set ofteeth and size of the teeth can be provided in order to be able toprovide for almost all patients. With this measure a time efficient andcost effective production method is achieved, and it is made possiblefor dentists and/or dental technicians to provide fully for thepopulation in all countries.

Unlike the known dental prostheses and production methods for the latterthe milling block according to the invention is based on a one-piecearrangement with a first region, which has a prosthesis base that can beprocessed according to the shape of the jaw, and a second region with apredetermined or standardised arrangement of synthetically moulded teethor rows of teeth for upper or lower jaw sets of teeth. Therefore, as apreliminary stage for the dental prosthesis a milling block is providedwhich, in a particularly cost- and time-saving manner, can only beprocessed, i.e. milled, in its first region, namely the prosthesis basein order to be adapted to the shape of the jaw. The milling block systemaccording to the invention comprises at least a first milling block forthe upper set of teeth and a second milling block for the lower set ofteeth, i.e. the preliminary stages of a partial or total prosthesis,which in the respective second region of the first and/or second millingblock has a predetermined or standardised arrangement of syntheticallymoulded teeth or rows of teeth for the upper and lower jaw sets of teethpositioned according to established occlusion principles.

A majority of premouldings known from the prior art with differentcolours, sizes and shape combinations for the mucous membrane region andtooth region for the production of the dental prosthesis is considerablysimplified with the present subject matter of the invention by thepredetermined or standardised arrangement of synthetically moulded,polymerised in teeth or rows of teeth for the upper or lower jaw sets ofteeth. According to the application it is advantageous that only therespective prosthesis base assigned to the mucous membrane region is tobe milled.

Moreover, the predetermined or standardised arrangement of syntheticallymoulded teeth or rows of teeth for the upper and lower jaw sets of teethpositioned according to established occlusion principles arenon-individualised, prefabricated dental prosthesis parts which do notrequire any further post-processing.

The predetermined or standardised arrangement of synthetically mouldedteeth or rows of teeth for the upper and lower jaw sets of teethpositioned according to established occlusion principles takes placeaccording to a selection of prefabricated dental prosthesis parts, i.e.synthetically moulded teeth or rows of teeth according to pre-specifiedand known positioning systems.

Other advantageous further developments of the invention are the subjectmatter of the sub-claims.

If, moreover, the synthetically moulded teeth and the prosthesis baseare made in one piece, when producing the milling block a casting orpressing mould can almost be used which therefore also respectively usesjust one material for the milling block which advantageously has both asmaller allergy potential and a higher bond strength.

If, advantageously, the milling block is configured in two parts, it isthus made possible for the first region, that is processed according tothe shape of the jaw, to be produced in a standardised manner and to bejoined to different teeth, likewise already positioned on a secondregion, which are of different sizes and have different factors. Withthe further development that the prosthesis base can be configuredflexibly, simplified adaptation to the oral cavity and adaptation to theshape of the jaw of the respective patient can be allowed for.

Materials featured as particularly advantageous for the milling blockand for the milling block system, i.e. the prosthesis base and/or teeth,are, among others, so-called PMMA plastics, as are also thermoplastics,organically and inorganically filled plastics and also low-allergyplastics. In addition, it is also advantageous to use any form ofceramic, in particular glass ceramics, leucite-reinforced ceramic,aluminium-reinforced ceramic, oxide ceramic, zirconium oxide ceramic,infiltration ceramic, feldspar ceramics, lithium disilicate ceramic. Itis also conceivable to use materials that have been sintered, but thatstill require a further production step. The milling block or themilling block system can also be used with a combined dental prosthesis.

If the teeth are already aligned according to an occlusion position,total adaptation to the patient's oral cavity is therefore onlyundertaken by appropriately milling the prosthesis base. The patient cantherefore be certain that with appropriate adaptation to the oral cavityor to the upper and lower jaw an optimal occlusion position is providedand so there is advantageously an unrestrictedly functional totalprosthesis as regards the bite characteristics. Due to the milling blockor milling block system according to the application and thecorresponding method for producing partial or total prostheses it ispossible, for example, to provide at least three different sizes withwhich a complete total prosthesis can be provided for almost everypatient according to the shape of the patient's face and the size of thepatient's oral cavity. Due to the simplicity of the adaptation of thetotal prosthesis the working steps for the adaptation to the oral cavityare therefore considerably reduced and so are also less expensive. Basedon experience, with specific groups of the population the milling blocksystem can also include just two types or more.

With regard to the preparation and positioning of the syntheticallymoulded teeth, with the milling block, milling block system according tothe invention and the corresponding method all possible, previouslyknown positioning systems for this purpose can be used, such as e.g. theso-called original positioning systems derived from Gysi, Gerber andSchreinemaker. Positioning systems according to APF and APF NT and TiFbased on the Gysi and Gerber positioning techniques can also be usedadvantageously. According to Staub Cranial a mathematically calculatingpositioning technique is used which determines the original position ofthe teeth on the basis of measurements taken and accordingly positionsagain.

The milling block or the milling block system according to theapplication can also be used in particular for the production of partialprostheses if at the very least opposite quadrants of the upper or lowersets of teeth can be used. Due to the positioning prepared for the teethin the occlusion position, after inserting in and adapting to thecorresponding jaw region post-processing of the teeth is therefore alsopractically unnecessary.

One particularly advantageous production technique for the milling blockor for the milling block system is the possibility of inserting theselected teeth, pre-polymerised, in the occlusion position in the firstregion of the prosthesis base and then only undertaking the finalpolymerisation upon joining to the second region of the prosthesis base.In this way it is made possible for the respective upper and lower jawprosthesis to be prepared and produced in one piece and form- andforce-fitted, and so it has a lower allergy potential and a higher bondstrength.

Further embodiments of the present invention are the subject matter ofthe other sub-claims.

With the milling block or milling block system according to theapplication it is made possible for fixing or marking of any type for azero position transfer or zero point transfer for the automatic CAD/CAMprocessing to be undertaken. This makes it possible to save a hugeamount of time, in particular due to dispensing with scanning, in orderto achieve the positioning and prevents defective processing in aCAD/CAM system.

The milling block and the milling block system according to theapplication and the method for producing partial or total prostheses aredescribed below in examples by means of the drawings.

In FIG. 1 a milling block 1 is shown which has a prosthesis base 3 whichis processed according to the shape of the jaw on which syntheticallymoulded teeth 5 of a full set of teeth are already provided. Thesynthetic teeth are already worked such that the teeth are alignedaccording to an occlusion position and so can interact optimally withthe upper jaw (not shown). In this illustration, for example, theprosthesis base and the teeth are made in one piece, and so theproduction process has been simplified.

In FIG. 2 the completed total prosthesis of the lower jaw is shown, theprosthesis base 3 already being adapted to the oral cavity. FIG. 2clearly shows how the shape of the oral cavity has been milled out ofthe prosthesis base, the teeth 5, which are aligned in the occlusionposition, remaining untreated. It is thus made possible with the methodaccording to the application that only by adapting the prosthesis baseis there a complete total prosthesis the occlusion of which is coherentand does not necessitate any further procedural step, such as forexample adaptation in an articulator. A further procedural step, asspecified for example in the prior art, namely subsequent alignment byarranging the teeth in wax in order to achieve the occlusion position,is not necessary with the method according to the application.

The invention claimed is:
 1. A method for producing a partial or totalprosthesis comprising a prosthesis base and synthetically molded teethor rows of teeth, the method comprising: determining contour data of anoral cavity of a patient defining a mucous membrane region; providing amilling block having a prosthesis base and synthetically molded teeth orrows of teeth, the synthetically molded teeth or rows of teeth beingpositioned according to established occlusion principles; milling theprosthesis base according to the patient contour data to provideoptimized adaptation and adjustment of the prosthesis base to thepatient mucous membrane of the oral cavity; wherein adaptation of theprosthesis to the mucous membrane of the patient's oral cavity isachieved only by the milling of the prosthesis base according to thepatient contour data of the mucous membrane of the oral cavity.
 2. Themethod of claim 1, wherein the prosthesis base and the syntheticallymolded teeth are made in one piece.
 3. The method of claim 1, whereinthe synthetically molded teeth are positioned in the prosthesis baseaccording to established occlusion principles and are aligned bymodifying the prosthesis base according to contour data of the oralcavity of the patient defining a mucous membrane region.
 4. The methodof claim 1, wherein the milling block comprises a ceramic selected fromthe group consisting of: glass ceramic, leucite-reinforced ceramic,aluminum-reinforced ceramic, oxide ceramic, zirconium oxide ceramic,infiltration ceramic, feldspar ceramics and lithium disilicate ceramic.5. The method of claim 1, wherein the prosthesis comprises a materialselected from the group consisting of: PMMA plastics, thermoplastics,PEEK nylon composite, organically and inorganically filled plastics,low-allergy plastics, out-burnable materials and sintered materials. 6.The method of claim 1, wherein the total prosthesis further comprises ametal base, a plastic base, or a ceramic base, and plastic teeth.
 7. Themethod of claim 1, wherein an upper set of synthetically molded teeth isformed using the first milling block and the method further comprisesforming a lower set of synthetically molded teeth from a second millingblock and wherein the synthetic teeth are aligned by modifying theprosthesis base according to contour data of the oral cavity of thepatient defining a mucous membrane region.
 8. The method of claim 7,wherein the teeth of the upper set of synthetically molded teeth and theteeth of the lower set of synthetically molded teeth are arranged inrelation to one another in an occlusion position by modifying theprosthesis base according to contour data of the oral cavity of thepatient defining a mucous membrane region.
 9. The method of claim 7,wherein the teeth of the upper set of synthetically molded teeth and theteeth of the lower set of synthetically molded teeth are positioned inthe prosthesis base according to established occlusion principles. 10.The method of claim 7, wherein the first and second milling blocks havepartial prostheses of at least opposite quadrants.
 11. The method ofclaim 7, wherein the synthetically molded teeth are polymerized into thecorresponding prosthesis base according to established occlusionprinciples.
 12. The method of claim 1, wherein preparation and/orprocessing of the first and the second milling block taking place bymeans of CAD/CAM systems.
 13. The method of claim 1, wherein thesynthetically molded teeth are positioned according to a Gysi, Gerber,APF, APF NT, TiF, Schreinemaker, and/or Staub Cranial positioningmethod.
 14. The method of claim 1, wherein the synthetically moldedteeth are joined to the prosthesis base by polymerization, by adhesivebonding, by pressing and/or melting together.
 15. The method of claim 1,further comprising inserting and adapting the shaped prosthesis base tothe contour of the oral cavity of a patient defining a mucous membraneregion.
 16. The method of claim 15, further comprising, after insertingand adapting the shaped prosthesis base, hardening or solidifying theshaped prosthesis base by heating, irradiating with light or by achemical reaction of at least two components present in the prosthesisbase.
 17. The method of claim 1, wherein the contour data of the oralcavity of the patient defining a mucous membrane region is CAD/CAM data.